Patient Complaints & Grievances

Purpose

In keeping with the School of Dentistry’s patient care goals, the School has a mechanism for receiving, responding to and resolving patient and family complaints concerning the quality of care, services, and facilities. Patients and families are informed of their rights to present complaints. Complaints are resolved in a fair and objective manner through the patient complaint process. The complaint is analyzed and, when indicated, corrective action is taken. Presentation of a complaint does not serve to compromise a patient’s future access to care and is a key component to the School’s Quality Improvement Program. (See Appendix A, Quality Improvement Flow Chart)

General Policy

All School of Dentistry faculty and employees serve as representatives of the School and are responsible for addressing a complaint when presented and making an appropriate referral. If a patient complaint cannot be resolved to the patient’s satisfaction, the patient can file a formal grievance with the Patient Services. The Patient Relations staff have the responsibility for the investigation and resolution of all patient grievances with input from Clinic Directors of specific departments based on the nature of the complaint.

Definitions

Complaint: Any patient-initiated issue or concern about patient care, a care provider, access to care or service quality that is expressed verbally or in writing.

Grievance: Any complaint that cannot be resolved to the satisfaction of the patient or family member lodging the complaint. A complaint will be considered a grievance when the patient or family member verbally declines to accept the written resolution of a complaint or writes to request further review into a complaint.

Implementation

I. Filing a Complaint

Patients and family members can register their complaint(s) or comment(s) in writing, by phone or in-person. The patient can file a complaint with the manager at the point of care or service, or with the Manager of Patient Services. The patient also has the right to contact the Washington State Department of Health. Issues are investigated in a professional and timely manner to achieve resolution when possible. Complaints received by phone or in-person are acknowledged, verbally or in writing, and a timeframe for resolution is set at the time of contact. The timeframe is determined by the nature of the issue to be investigated.

The School’s goal is to acknowledge written complaints within five working days of receipt by the Manager of Patient Services (For privacy complaints related to UW School of Dentistry Privacy Practices, contact the Compliance Director. Such complaints will be investigated within 10 days of the complaint.) The full investigation and resolution process should not exceed 60 working days from receipt of complaint. If a complaint requires additional time for resolution, a timetable for resolution will be made with the input from the patient and School of Dentistry staff. The School will endeavor to respond to complaints in fewer than 60 days when practical to do so.

II. Resolving Complaints

A. Staff will initiate problem resolution (see Appendix B—School of Dentistry Resolving Patient Complaints Quick Reference Guide). If the staff member who receives the complaint cannot resolve the concern, the issue will be referred to the Manager of Patient Services. Staff will inform the patient or family member where their complaint is being referred. A description of the issue is conveyed by the referring staff to the Manager of Patient Services when possible to avoid having the patient or family member repeat his/her complaint (see Attachment 2: Patient Complaints Procedure).

B. Complaints regarding quality of care, informed consent or breach of patient privacy should be referred immediately to the Manager of Patient Services who will consult with the Associate Dean for Clinical Affairs, the Director of Quality Improvement and with Health Sciences Risk Management, as necessary.

C. If a comment/complaint card is received or if there is an in-person complaint, the staff person will review the process. If multiple departments are involved in resolving a complaint, the Manager of Patient Services will serve as a direct follow-up resource for the individual who registered the complaint.

D. If a complaint cannot be resolved to the patient’s satisfaction, the patient or family member will be told he/she has the option to file a grievance with the Manager of Patient Services.

III. Patient Grievance Process

If a patient chooses to initiate the patient grievance process, he/she can file a grievance with the office of the Associate Dean for Clinical Services. This office will complete the initial review of the grievance and present the issue to the Patient Grievance Committee. Complete investigation of the grievance will be assigned based on the type of grievance involved. Patients will be notified in writing of the receipt of their grievance within five business days. The resolution will occur within a timeframe agreed upon between the patient and the School. The School of Dentistry Patient Grievance Committee will be responsible for reviewing and resolving all grievances. Patients also have other forums for complaints, such as the Washington State Department of Health or the Seattle King County Dental Society.

IV. Notice of Complaint Process

Patients are notified of their rights regarding filing a complaint in the following ways:
A. The Patient Rights and Responsibilities brochure which is given to patients before or at the time of service.
B. Signs in reception areas and in clinics with contact numbers of the Clinic Manager and Manager of Patient Services.
C. Patient comment brochures which are available throughout the school.

V. Quality Improvement

Overall trends related to patient complaints are presented to the School of Dentistry Coordinated Quality Improvement Operations Committee (CQIP) and the School’s Clinic Services Committee, for performance and quality improvement.